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Dealing with chronic constipation – The Washington Post



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It’s regular to have an occasional bout of constipation. Uncomfortable as it might be, this normally resolves inside just a few days. However the issue could also be continual — and require some motion — in case you have no less than two of the next signs for no less than three months:

  • You may have fewer than three bowel actions per week.
  • You should pressure for no less than 1 / 4 of all of your bowel actions.
  • Stool is usually exhausting or lumpy.
  • Typically you are feeling like your bowels haven’t been absolutely emptied.

For aid, individuals with continual constipation could turn to laxatives.

“Many older adults assume that constipation is simply one other inevitable a part of ageing, however it may be averted by means of way of life [strategies and] occa­sion­ally treatment,” says Christian Stevoff, a gastroenterologist at Northwestern Drugs in Chicago.

Know the causes of continual constipation

Continual constipation may be extra frequent in older adults, affecting about 26 % of girls and 16 % of males over age 65, and 34 % of girls and 26 % of males older than 85, in accordance with a 2021 study.

“As we age, our intestine and nervous system additionally age, and one of many penalties of that’s the degeneration of nerves and muscular tissues (that transfer waste alongside) in order that they don’t operate in addition to they used to,” says Satish Rao, chief of gastroenterology at Augusta College in Georgia.

However different elements, includ­ing inadequate fiber and too little bodily exercise, can even contribute. Medicines equivalent to opioids and sure antidepressants, blood stress meds and Parkinson’s illness medicine are all potential culprits, Stevoff says.

Some over-the-counter (OTC) ache relievers, equivalent to ibuprofen and naproxen, are additionally related to constipation, and dietary supplements that comprise calcium or iron “can bind you up,” says William Chey, a gastroenterologist on the College of Michigan in Ann Arbor.

Hypothyroidism or neurological points equivalent to a number of sclerosis can result in constipation, too, as can pelvic flooring issues — which have an effect on the flexibility to coordinate muscular tissues to push stool out, says David Poppers, a gastroenterologist at NYU Langone Well being in New York.

Strive these way of life steps

Life-style methods could be fairly efficient when you proceed them, however they’ll take a number of weeks to start working. For those who want quick aid — for instance, you haven’t handed stool in a number of days — you may think about using an OTC osmotic laxative with polyethylene glycol (PEG), Stevoff says. (For some, stimulant laxatives, equivalent to senna and bisacodyl, could have harsher unintended effects than PEG-based drugs.)

At all times let your physician know when you haven’t had a bowel motion in a number of days. For the lengthy haul, attempt these methods:

  • Enhance your fiber. It helps bulk up stool, making it simpler to cross. Analysis means that consuming 5 or 6 prunes every day is nearly as good for continual constipation as some laxatives, Rao says. Or attempt consuming two kiwi­fruits a day; Chey’s research finds that it relieves constipation in about half of individuals, with out among the unintended effects of prunes, equivalent to stomach ache, bloating and gasoline.
  • Ramp up your fiber intake. Do this over a interval of days to weeks to permit your physique to get used to it, Chey says. For those who discover it exhausting to get sufficient fiber by means of meals, take into account taking an OTC fiber complement. The perfect proof is for people who comprise psyllium, Poppers says.
  • Drink sufficient fluids. Attempt to drink about eight 8-ounce cups of fluid day-after-day. A cup of espresso may also be useful as a result of it’s a gentle gastro­­intestinal stimulant. Many older adults are perpetually dehydrated, which might worsen constipation, Chey says.
  • Take note of timing. Your bowels are usually most energetic inside a couple of half-hour after a meal, so ensure you have entry to a bathroom then. It’s effective to spend about 5 to 10 minutes within the rest room, but when nothing occurs in that point, attempt later within the day, Poppers says.
  • Undertake the precise posture. You wish to hold your knees above your hips, which relaxes pelvic flooring muscular tissues that loop across the again of your rectum, says Carrie Pagliano of the American Bodily Remedy Affiliation. “This manner it supplies a straight shot for BMs to exit,” she says. One choice is to take a seat on the bathroom along with your ft on a small footstool, such because the Squatty Potty. And keep away from straining­.
  • Train. A 2017 study discovered that ladies with continual constipation who walked on a treadmill for 60 minutes 3 times every week for 12 weeks reported an enchancment in contrast with a management group.

For those who want long-term assist

For those who’ve tried way of life modifications for 3 to 4 weeks and nonetheless expertise some continual constipation, see your physician, Stevoff says. A doctor can do bloodwork to rule out medical situations, evaluation your meds and dietary supplements, and, if needed, carry out exams equivalent to a colonoscopy to examine for an obstruction or a blockage. In case your continual constipation is prompted or worsened by pelvic flooring issues, your physician could advocate pelvic flooring bodily remedy, the place you’ll be taught strategies equivalent to stomach therapeutic massage that may assist get issues transferring once more.

When there’s no clear trigger, Rao says prescription medications could possibly be an choice — quickly or in some circumstances long-term.

When the issue turns into extreme

In case your constipation is unresolved for too lengthy, it might probably result in fecal impaction, the place a lump of dry, exhausting stool turns into caught within the rectum.

Along with constipation, this could convey stomach ache and a sense of fullness that impacts urge for food. Fecal impaction can even result in diarrhea, due to watery stool from larger up within the gastrointestinal tract passing round caught stool, Rao says.

A health care provider can diagnose fecal impaction with a digital rectal examination and X-rays. They could attempt to take away the impaction manually or administer a warm-water enema to flush it out. If it doesn’t reply to those measures, or in case your physician sees indicators of a perforated colon, you may want emergency surgical procedure.

As soon as the stool is eliminated, your physician will advocate a laxative or different steps to stop a recurrence, equivalent to rising fiber consumption and staying energetic. You’ll additionally wish to speak to your physician about drugs that will contribute.

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